Preparing Medical Students to Address the Needs of Vulnerable Patient Populations: Implicit Bias Training in US Medical Schools

This article examines the mechanisms and arrangements for the movement of subjects for dissection at Aberdeen after the Anatomy Act, and the methods adopted by the Inspector of Anatomy for Scotland and the teachers of anatomy to implement the Act. There has been limited research on the working of the Anatomy Act in Scotland, which this paper aims to address by demonstrating the uniquely Scottish manner of implementation of the Anatomy Act through the use of the Funeratory system, which worked remarkably smoothly. Regimes and arrangements associated with the dissection and disposal of anatomical remains in the city provide statistics, and give details of unclaimed paupers who became ‘material contributions’ for Aberdeen anatomists and medical students.

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Mentors' experiences in an osteopathic medical student research program

Journal of Osteopathic Medicine ◽

10.1515/jom-2020-0251 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Tyler Hamby ◽

W. Paul Bowman ◽

Don P. Wilson ◽

Riyaz Basha

Keyword(s):

Medical Students ◽

Research Program ◽

Online Survey ◽

Medical Schools ◽

Systematic Instruction ◽

Medical Student Research ◽

Research Programs ◽

Student Mentor ◽

The University

Abstract Context Medical students, especially at osteopathic medical schools, have limited research exposure. Systematic instruction in research, supervised by qualified mentors, could motivate osteopathic medical students to pursue research in their careers, thereby increasing the number of future clinician-scientists. Recruiting and retaining suitable research mentors are crucial to sustaining such programs, but this task is also particularly challenging for osteopathic medical schools. Objectives To assess mentors' experiences in a voluntary student-mentor medical research program. Methods An online survey was sent to 76 university- or hospital-based participants who previously mentored 219 medical students between 2014 and 2019. The questionnaire consisted of 13 items with responses in checklist, five-point Likert scale, and categorical multiple-choice formats, assessing motivation for participation, satisfaction with the program, and interest in future participation. Data were analyzed descriptively, and responses from mentors at the university and hospital were compared using univariate logistic and ordinal regression analyses. Results Among 70 (92.1%) mentors who responded to the survey, 61 (87.1%) reported being motivated by a desire to help medical students learn research. Forty-nine (70.0%) mentors indicated that furthering their own research productivity was a motivation, and hospital-based mentors were statistically significantly more likely to endorse this source of motivation (OR=2.02; 95% CI=1.18–3.45; p=0.01). Most respondents were satisfied with the quality of the students' work (59 [84.3%]) and with the program (59 [85.5%]). However, 46 (65.7%) suggested the program could be enhanced by requiring medical students to be physically present in the clinic or laboratory for a minimum amount of time. Importantly, most (58 [84.1%]) mentors reported that they would be interested in participating in future mentored research programs. Conclusions Mentors were motivated to participate in the voluntary research program for both altruistic and professional reasons. Since most mentors reported being satisfied with the program, it is likely they would participate in future mentored research programs. Our results suggest that mentors viewed this voluntary research program as mutually beneficial.

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Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211018696 ◽

2021 ◽

Vol 8 ◽

pp. 238212052110186

Author(s):

Lisa M Meeks ◽

Ben Case ◽

Erene Stergiopoulos ◽

Brianna K Evans ◽

Kristina H Petersen

Keyword(s):

Medical Education ◽

Medical Students ◽

Students With Disabilities ◽

Class Size ◽

Medical Schools ◽

Organizational Characteristics ◽

School Level ◽

Student Diversity ◽

Structural Barriers ◽

Disability Disclosure

Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied. Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size. Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size. Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.

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A Scoping Review of Professional Identity Formation in Undergraduate Medical Education

Journal of General Internal Medicine ◽

10.1007/s11606-021-07024-9 ◽

2021 ◽

Author(s):

Shiva Sarraf-Yazdi ◽

Yao Neng Teo ◽

Ashley Ern Hui How ◽

Yao Hao Teo ◽

Sherill Goh ◽

...

Keyword(s):

Medical Students ◽

Identity Development ◽

Medical School ◽

Professional Identity ◽

Identity Formation ◽

Scoping Review ◽

Medical Schools ◽

Professional Identity Formation ◽

Enabling Factors ◽

Content Analyses

Abstract Background Professional identity formation (PIF) in medical students is a multifactorial phenomenon, shaped by ways that clinical and non-clinical experiences, expectations and environmental factors merge with individual values, beliefs and obligations. The relationship between students’ evolving professional identity and self-identity or personhood remains ill-defined, making it challenging for medical schools to support PIF systematically and strategically. Primarily, to capture prevailing literature on PIF in medical school education, and secondarily, to ascertain how PIF influences on medical students may be viewed through the lens of the ring theory of personhood (RToP) and to identify ways that medical schools support PIF. Methods A systematic scoping review was conducted using the systematic evidence-based approach. Articles published between 1 January 2000 and 1 July 2020 related to PIF in medical students were searched using PubMed, Embase, PsycINFO, ERIC and Scopus. Articles of all study designs (quantitative and qualitative), published or translated into English, were included. Concurrent thematic and directed content analyses were used to evaluate the data. Results A total of 10443 abstracts were identified, 272 full-text articles evaluated, and 76 articles included. Thematic and directed content analyses revealed similar themes and categories as follows: characteristics of PIF in relation to professionalism, role of socialization in PIF, PIF enablers and barriers, and medical school approaches to supporting PIF. Discussion PIF involves iterative construction, deconstruction and inculcation of professional beliefs, values and behaviours into a pre-existent identity. Through the lens of RToP, factors were elucidated that promote or hinder students’ identity development on individual, relational or societal levels. If inadequately or inappropriately supported, enabling factors become barriers to PIF. Medical schools employ an all-encompassing approach to support PIF, illuminating the need for distinct and deliberate longitudinal monitoring and mentoring to foster students’ balanced integration of personal and professional identities over time.

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Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial

Journal of General Internal Medicine ◽

10.1007/s11606-020-06571-x ◽

2021 ◽

Author(s):

Judith K. Ockene ◽

Lori Pbert ◽

Sybil Crawford ◽

Christine F. Frisard ◽

Jyothi A. Pendharkar ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Medical Students ◽

Weight Management ◽

Management Education ◽

Controlled Trial ◽

Health Behavior Change ◽

Medical Schools ◽

Randomized Controlled ◽

Weight Management Counseling ◽

Overweight Or Obesity

ABSTRACT BACKGROUND Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts. OBJECTIVE To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change. DESIGN A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U.S. medical schools randomized to receive either multi-modal weight management education (MME) or traditional weight management education (TE). SETTING/PARTICIPANTS Students from the class of 2020 (N=1305) were asked to participate in an objective structured clinical examination (OSCE) focused on weight management counseling and complete pre and post surveys. A total of 70.1% of eligible students (N=915) completed the OSCE and 69.3% (N=904) completed both surveys. INTERVENTIONS: The MME implemented over three years included a web-based course, a role-play classroom exercise, a web-patient encounter with feedback, and an enhanced clerkship experience with preceptors trained in weight management counseling (WMC). Counseling focused on the 5As (Ask, Advise, Assess, Assist, Arrange) and patient-centeredness. MEASUREMENTS The outcome was student 5As WMC skills assessed using an objective measure, an OSCE, scored using a behavior checklist, and a subjective measure, student self-reported skills for performing the 5As. RESULTS Among MME students who completed two of three WMC components compared to those who completed none, exposure was significantly associated with higher OSCE scores and self-reported 5A skills. LIMITATIONS Variability in medical schools requiring participation in the WMC curriculum. CONCLUSIONS This trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management. NIH Trial Registry Number R01-194787

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Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽

10.3390/medicina49060045 ◽

2013 ◽

Vol 49 (6) ◽

pp. 45

Author(s):

Kamila Faizullina ◽

Galina Kausova ◽

Zhanna Kalmataeva ◽

Ardak Nurbakyt ◽

Saule Buzdaeva

Keyword(s):

Medical Students ◽

Human Resources ◽

Rural Areas ◽

Urban Areas ◽

Human Resources For Health ◽

Medical Schools ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Unequal Distribution ◽

Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

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Self-Assessment of Problem Solving Disposition in Medical Students

Journal of Biomedical Education ◽

10.1155/2014/161204 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Silvia Lizett Olivares-Olivares ◽

Mildred Vanessa López-Cabrera

Keyword(s):

Health Care ◽

Medical Education ◽

Medical Students ◽

Problem Solving ◽

Medical Schools ◽

Self Assessment ◽

Competency Based Education ◽

Competency Based ◽

Future Demands ◽

Disposition Model

Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 experts in medical education and applied to 135 registered students on the sixth year of the M.D. Physician Surgeon program at a private medical school. Cronbach’s alpha indicated an internal consistency of 0.751. The findings suggest that selected items have both homogeneity and validity. The factor analysis resulted in components that were associated with three problem-solving subcategories. The students’ perceptions are higher in the pattern recognition and application of general strategies for problem solving subcategories of the Problem solving disposition model.

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The Impact of a Novel Outdoor Orientation Program on Incoming Medical Students

Journal of Experiential Education ◽

10.1177/10538259211048611 ◽

2021 ◽

pp. 105382592110486

Author(s):

Jacquelyn B. Kercheval ◽

Alec Bernard ◽

Hanna Berlin ◽

Nicole Byl ◽

Boone Marois ◽

...

Keyword(s):

Medical Students ◽

Medical School ◽

Personal Development ◽

Medical Schools ◽

Orientation Program ◽

Outdoor Orientation Programs ◽

One Year ◽

The Impact ◽

Outdoor Orientation ◽

Outdoor Orientation Program

Background: Undergraduate outdoor orientation programs facilitate students’ transition into college. Research has yet to be conducted on the few programs at medical schools, which may have unique benefits given the specific challenges of transitioning to medical school and high rates of burnout among medical students. Purpose: This mixed methods study examines the impact of one medical school's outdoor orientation program on its participants. Methodology/Approach: A survey was administered immediately following the 2018 trip ( N = 56 responses). Follow-up focus groups were conducted with a sample of the same participants ( N = 18) in 2019. Responses were analyzed using descriptive statistics and thematic analysis. Findings/Conclusions: Participants felt that the program helped ease their transition into medical school, establish a support system, and hone personal development and wellness skills. Many of these effects persisted up to one year later. Implications: These findings are of particular interest to the medical and experiential education communities because many outcomes persisted for at least one year after the original trip and aligned with factors believed to protect against medical student burnout. There is opportunity for additional research as well as expansion of similar programs to other medical schools.

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Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

Canadian Urological Association Journal ◽

10.5489/cuaj.3679 ◽

2016 ◽

Vol 10 (7-8) ◽

pp. 281

Author(s):

Kristen McAlpine ◽

Stephen Steele

Keyword(s):

Medical Students ◽

Clinical Training ◽

Clinical Skills ◽

Medical Schools ◽

Clinical Settings ◽

Undergraduate Medical Students ◽

Canadian Medical School ◽

Competency Based ◽

English Speaking ◽

And Training

Introduction: The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.Methods: This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.Results: A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.Conclusions: To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.

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